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Refractive Error in Chinese Preschool Children: The Shanghai Study
Tao Li1, Xiaodong Zhou, Xuefeng Chen
1Department of Ophthalmology (T.L., X.Z.), Fudan University Jinshan Hospital, Shanghai, China; and Jinshan District Eye Disease Prevention and Treatment Center (X.Z., X.C., H.Q., Q.G.), Shanghai, China.
Insights
This study found a high prevalence of refractive errors in Chinese preschoolers, with myopia, hyperopia, and astigmatism affecting over 19% of children. Factors like being female and body composition were linked to myopia development.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Public Health
Background:
- Refractive errors are a significant global health concern, particularly in children.
- Early detection and intervention are crucial for preventing long-term vision impairment.
Purpose of the Study:
- To determine the prevalence of refractive errors (myopia, hyperopia, astigmatism) in Chinese preschool children.
- To identify associated factors influencing refractive error development in this age group.
Main Methods:
- A school-based survey of 7,166 children aged 4-6 years in Shanghai.
- Refractive error assessed via noncycloplegic autorefraction.
- Axial length, body height, and weight were also recorded.
Main Results:
- Overall prevalence: myopia 5.9%, hyperopia 1.0%, astigmatism 12.7%.
- Spherical equivalent median: +0.25 D.
- Myopic spherical equivalent associated with female sex, longer axial length, taller, and lighter children.
Conclusions:
- Shanghai exhibits a high prevalence of refractive errors among preschool children.
- Further longitudinal studies are essential to track refractive changes and inform myopia prevention strategies.
Purpose:
To examine the prevalence of refractive error and some associated factors in Chinese preschool children.
Methods:
The Jinshan District Eye Study was a school-based survey of eye health in a large sample of 4- to 6-year-olds attending kindergartens from May 2013 to December 2013 in Shanghai. Refractive error was measured using an autorefractor under noncycloplegic conditions. Axial length (AL) was measured with an ocular biometry system. In addition, body height and weight were also recorded.
Results:
A total of 7,166 children successfully completed their refraction measurements. The median (interquartile range) of spherical equivalent (SE) for all the children was +0.25 D (-0.13 D to +0.62 D), and the range was -15.88 to +18.13 D. The mean AL for all the children was 22.35±0.70 mm, and the range was 18.20 to 27.71 mm. The overall prevalence of myopia (-1.00 D or less), hyperopia (+2.00 D or greater), and astigmatism (1.00 D or greater) were 5.9%, 1.0%, and 12.7%, respectively. After multivariate analysis, more myopic SE (or less hyperopic SE) was significantly associated with girls, longer AL, taller, and lighter.
Conclusion:
Shanghai has a high prevalence of refractive error in the world. However, longitudinal studies are needed to evaluate refractive changes over time in individual children and warranted to prevent the development of myopia.
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